4723-26-08 Criteria and standards for a registered nurse delegating to a community health worker.

(A) A registered nurse may delegate a nursing task or activity to a community health worker if all the conditions for delegation set forth in this chapter are met.

(B) When delegating a nursing task or activity to a community health worker, the delegating registered nurse shall determine that the following conditions are met:

(1) The nursing task or activity is within the scope of practice of a registered nurse as set forth in section 4723.01 of the Revised Code;

(2) The nursing task or activity is within the knowledge, skill, and ability of the registered nurse delegating the nursing task or activity;

(3) The nursing task or activity is within the training, skill, and ability of the community health worker who will be performing the delegated nursing task or activity;

(4) The nursing task or activity is delegable as specified in this rule;

(5) Appropriate resources and support are available for the performance of the nursing task or activity, and for management of the outcome;

(6) Adequate and appropriate supervision by the registered nurse of the performance of the nursing task or activity is available in accordance with this rule; and

(7) The community health worker shall perform the delegated task or activity only as specified by the registered nurse.

(C) Prior to the delegation of any nursing task or activity to a community health worker, a registered nurse shall:

(1) Identify:

(a) The individual on whom the nursing task or activity may be performed; and

(b) A specific time frame during which the delegated nursing task or activity may be performed.

(2) Complete an evaluation of the conditions that relate to the delegation of the nursing task or activity to be performed, including:

(a) An evaluation of the individual who needs nursing care;

(b) The types of nursing care the individual requires;

(c) The complexity and frequency of the nursing care needed;

(d) The stability of the individual who needs nursing care; and

(e) A review of the evaluations performed by other licensed health care professionals.

(3) Identify a nursing task or activity as delegable if all the following apply:

(a) The nursing task or activity requires no judgment based on nursing knowledge and expertise on the part of the community health worker performing the task;

(b) The results of the nursing task or activity are reasonably predictable;

(c) The nursing task or activity can be safely performed according to exact, unchanging directions, with no need to alter the standard procedures for performing the task;

(d) The performance of the nursing task or activity does not require that complex observations or critical decisions be made with respect to the nursing task or activity;

(e) The nursing task or activity does not require repeated performance of nursing assessments by the delegating registered nurse; and

(f) The consequences of performing the nursing task or activity improperly are minimal and not life-threatening.

(D) The registered nurse shall be accountable for the acts of delegation to and supervision of the community health worker in the performance of the delegated nursing task or activity.

(E) If a registered nurse determines that a community health worker is not performing a delegated task or activity according to the community health worker’s training and in accordance with the registered nurse’s direction, the registered nurse shall immediately withdraw the delegation.

(F) A registered nurse shall not be responsible for the delegation of a nursing task or activity by another licensed health care practitioner to a community health worker.

HISTORY: Eff 2-1-05

Rule promulgated under: RC 119.03

Statutory Authority: 4723.88

Rule Amplifies: 4723.82

R.C. 119.032 review dates: 02/01/2010